Individual
MRS. KRISTA HERRYGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
610 N MICHIGAN ST, SUITE 306, SOUTH BEND, IN 46601-1077
(574) 647-6500
(574) 647-6518
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001800A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000924930
BCBS BMG CARDIOTHORACIC SURGERY SB
IN
01
—
000000924933
BCBS BMG CARDIOTHORACIC SURGERY ELKHART
IN
01
—
P01666309
RR MEDICARE
IN
Enumeration date
03/25/2015
Last updated
05/02/2017
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